| Payment ID | 63997 |
|---|---|
| Date Created | 04/15/24 10:50 am |
| Created By | Gloria Jimenez |
| Service Request | 61989 |
| Application ID | 27271 |
| Authorization Number | 223707 |
| Applicant Information | |
| Name | Susanna Alvarez |
| Agency Name | Housing Authorities |
| Agency | Housing Authorities |
| Applicant Email Address | Email hidden; Javascript is required. |
| Unique Identifier | 16170501756 |
| Payment Type | Short-Term Hotel/Motel Stays |
| Type of Service Request | Hotel Stay |
| Location Contact Name | Crystal |
| Location Email Address | Email hidden; Javascript is required. |
| Start Day | Monday |
| Guests | 3 |
| From | 03/20/2024 |
| To | 03/27/2024 |
| Days | 7 |
| Payment Details | |
| Payment Amount | $300.93 |
| Receipt Amount | $855.00 |
| Receipt Date | 04/12/2024 |
| Comments | hotel stay at Delta Inn, this payment includes more than one service request |
| Receipt | 63997-Alvarez.pdf |
| Staff Name | Gloria |
| Case Manager | DJ |
| Case Worker Email | Email hidden; Javascript is required. |
| Verifier Name | Gloria Jimenez |
| Verifier Signature | |
| Date Verified | 04/15/2024 |
